Acquired Brain Injury
Training Techniques | Characteristics | Implications for Sailing
WHAT IS AN ACQUIRED BRAIN INJURY (ABI) ?
An acquired brain injury is a loss of brain function as a result of damage to the brain which occurs after birth. It refers to injuries to the brain caused by trauma such as from an external force, which may result in unconsciousness or a diminished or altered state of consciousness.
CAUSES OF ABI
The term Traumatic Brain Injury (TBI) refers to those injuries to the brain caused by an external force. This may result from -
- Motor Accidents
- Sporting Accident
- Assault
Other conditions which may result in damage to the brain (Acquired Brain Injury) include -
- Tumour
- Stroke
- Infection
- Substance abuse
- Medical mistake
- Accidents
The term Acquired Brain Injury (ABI) encompasses all injuries which occur to the brain after birth.
HOW LONG DOES IT LAST?
The effects of ABI can be temporary or permanent. The period of rehabilitation and the outcome of a brain injury will vary from person to person depending on the degree of damage that has occurred and the area or part of the brain affected. For this reason, some people who acquire a brain injury may incur multiple disabilities.
It should be stressed that people with ABI differ considerably from people with an intellectual disability. People with brain injuries usually retain their intellectual abilities but may have difficulty controlling, co-ordinating and communicating their thoughts and actions.
TRAINING TECHNIQUES
An injury to the brain can result in partial or total impairments of cognitive, physical and/or sensory function. Whilst recovery from physical conditions might indicate minimal impairment of athlete, there is often a change in the behavioural and emotional functioning as a person adapts to the changes in their life. For this reason, ABI is often referred to as the "hidden disability".
INSTRUCTIONS
A person with ABI usually retains their intellectual capacity after their injury, however, depending on the area of the brain which has been affected, there may be a problem in learning new skills because of the difficulty in processing information. Also, a person often has a problem in recognising their own limitations due to lack of insight as a result of damage to the frontal lobes.
With regards to instruction the following guidelines are recommended:
- Always talk slowly and clearly - do not provide too much information in any one session.
- Break down task into components.
- Be prepared to repeat procedures the following session.
- Use of visual aids both during lessons and on the boat if possible (i.e. use of picture cards and visual cues).
- Ensure written material is in large type wherever possible (in font 14 plus etc.) as people with ABI often have difficulty reading written material.
- Ensure that trainee keeps a diary for planning, including training sessions and race schedules.
CHARACTERISTICS
PHYSICAL & SENSORY
Physical considerations may include:
- an increased degree of spasticity,
- poor co-ordination and mobility,
- muscle weakness and
- susceptibility to fatigue.
Often a person might experience a loss of sensory function, such as a decrease in visual acuity.
COGNITIVE
Cognitive factors will vary for each individual but problems can occur with:
- spatial orientation
- motivation
- judgement
- memory loss
- difficulty in transferring information.
Each coach will need to determine the amount of information that can be processed by an athlete, including the capacity of short and long term memory.
OTHER CONSIDERATIONS
In some instances, people with ABI might often exhibit inappropriate social behaviour. Whilst this is minimal, it is an aspect of brain injury which people should be aware, to ensure minimum offence to others, especially considering the social aspect of sailing.
MEDICAL CONSIDERATIONS
- Always attain a medical report or assessment of an individual including medication requirements and medical approval for participation in proposed activities.
- Consult with individual, doctor and parent or carer to identify any issues, problem areas, medication etc.
- Epilepsy - people with ABI are more likely to develop epilepsy after their injury. For this reason, it is essential that coaches, carers etc. have an awareness of epilepsy and a knowledge of how to treat epileptic seizures.
IMPLICATIONS FOR SAILING
- Balance can often be a problem - this should be taken into consideration, especially when on larger boats.
- Vision - Always check to see if there are any vision problems - people with ABI have problems with visual acuity.
- Depending on the degree of injury , it may be necessary to use modified equipment e.g. electronic controls etc.
FATIGUE
A person with ABI is very susceptible to fatigue. Once a person is fatigued they are more susceptible to accidents, bouts of frustration, become easily stressed and therefore more likely to exhibit negative or inappropriate behaviour.
For this reason, the following guidelines should be implemented to facilitate an easier learning experience for both instructor and trainee.
- Plan information or training sessions early in the day.
- Keep sessions short as concentration if often a problem and to minimise onset of fatigue.
- Ensure appropriate rest periods are programmed into training schedules.
- If racing, be prepared to change and distribute responsibilities within the crew.
FRUSTRATION
- A person with ABI will often remember all the activities they could perform prior to their accident.
- Do not always presume that a person is capable of performing a task independently. It is often the case that the person will not be able to acknowledge initially that they are unable to perform certain tasks - the lack of insight is a common issue for people with ABI.
- Always provide encouragement and positive reinforcement at all times.
MOTIVATION
People with ABI tend to exhibit a lack of motivation on many occasions. To address this issue, contact person prior to the day, on the day and as transport is often an issue, arrange transport with someone at set times to ensure opportunity for participation sailing or training day.
OTHER GUIDELINES
- Always consult with carers prior to beginning an activity. Apart from safety, this will try and eliminate situations where the trainee will be uncomfortable and become stressed.
- As ABI is a hidden disability, sometimes, the disability is only apparent where there is an inability to cope in stressful situations.
- People with ABI wish to live independent and would like to treated as an individual, be involved and integrated into the club or community wherever possible.
